Anthrax Victims Suffering Long After Attacks

First Look at Long-Term Effects of Bioterrorism continued...

The researchers noted that medical tests often could not pinpoint the cause of their complaints.

For example, eight survivors reported moderate to severe joint problems, decreased physical functioning, and prolonged work absence. But 11 diagnostic tests, including X-rays and lab tests, performed on six of these patients showed no signs of immune or inflammatory disorders or other common medical explanations for these symptoms.

Reissman says those findings suggest that posttraumatic stress disorder (PTSD) may be responsible for some of the physical as well as psychological symptoms.

"Since we were not able to link from a causal point of view the ongoing health problems with the anthrax infection or the toxins released by the bacteria, we're left with the traumatic situation," says Reissman.

Luciana Borio, MD, senior fellow at the Center for Biosecurity at the University of Pittsburgh Medical Center, says it's not unusual for PTSD in the wake of a terrorist event to cause a variety of physical symptoms, the cause of which cannot always be determined through conventional medical testing.

"The way people perceive physical symptoms sometimes is difficult to measure and may be due to psychosocial distress," Borio tells WebMD. "These symptoms seem more consistent with PTSD -- not because they're not there, but because we can't measure it."

As further evidence that the symptoms may have a psychological basis, the study showed that the severity of the complaints among the victims was nearly the same between the inhalational and cutaneous anthrax survivors except in the areas of physical and social functioning. In those measures, inhalational anthrax survivors tended to suffer more due to the severity of their disease.

Bioterrorist Attacks Cause More Than Disease

To put their results into context, researchers compared their findings to studies on long-term survivors of other infectious diseases and persons with chronic health conditions because there is so little information on the long-term effects of anthrax.

In comparison, anthrax survivors had a harder time adjusting to life after infection and fared far worse than persons with chronic illness on most measures, such as physical functioning, bodily pain, and mental health.